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Tratamiento de la vasculitis sistémica con inmunoglobulinas intravenosas agrupadas
D R Jayne1, M J Davies, C J Fox
1Department of Medicine, School of Clinical Medicine, University of Cambridge, UK.
Lancet (London, England)
|May 11, 1991
Resumen
La terapia de dosis altas de inmunoglobulina intravenosa (IVIg) mostró una mejora clínica significativa en pacientes con vasculitis sistémica. Este tratamiento redujo efectivamente la actividad de la enfermedad y los anticuerpos de citoplasma antineutrófilos circulantes (ANCA).
Área de la Ciencia:
- Inmunología Inmunología.
- Reumatología Reumatología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- La vasculitis sistémica se caracteriza por la inflamación de los vasos sanguíneos.
- La inmunosupresión convencional puede ser insuficiente para algunos pacientes.
- Los anticuerpos del citoplasma antineutrófilo (ANCA) a menudo están implicados en la patogénesis de la vasculitis.
Objetivo del estudio:
- Para evaluar la eficacia terapéutica de las altas dosis de inmunoglobulina intravenosa conjunta (IVIg).
- Evaluar el impacto de IVIg en la actividad de la enfermedad y los niveles de ANCA en la vasculitis sistémica.
Principales métodos:
- Una cohorte de 7 pacientes con vasculitis sistémica fue tratada con dosis altas de IVIg.
- Los pacientes incluyeron aquellos con enfermedad activa en inmunosupresión y individuos naivos al tratamiento.
- Se monitorearon la mejora clínica, las concentraciones de ANCA y los niveles de proteína C reactiva.
Principales resultados:
- Los 7 pacientes experimentaron una mejoría clínica, sostenida en 6.
- Las concentraciones medias de ANCA disminuyeron en un 51% y se mantuvieron bajas durante el seguimiento.
- Se observaron reducciones significativas en los niveles de proteína C reactiva.
Conclusiones:
- Las dosis altas de IVIg ofrecen un efecto terapéutico beneficioso para la vasculitis sistémica.
- El tratamiento IVIg parece seguro, sin reacciones adversas reportadas en esta serie.
- IVIg puede ser una valiosa adición al tratamiento de la vasculitis asociada a ANCA.
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